腹腔镜治疗难治性多囊卵巢综合征38例临床分析  

Laparoscopic treatment of clomiphene-resistant polycystic ovarian syndrome: A clinical analysis of 38 cases

作　　者：沈雷[1] 黄蓉[1] 郭玉霞[1] 刘斌[1] 

机构地区：[1]暨南大学第二附属医院深圳市人民医院妇产科,深圳518020

出　　处：《中国微创外科杂志》2007年第3期213-214,共2页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的探讨腹腔镜对难治性多囊卵巢综合征(polycystic ovary syndrome,PCOS)不孕的治疗效果。方法2001年3月-2005年5月,我院对38例PCOS不孕症行腹腔下卵巢多点打孔术及盆腔粘连松解、输卵管成形术,手术前后分别测血清黄体生成素(LH)、卵泡刺激素(FSH)、雄激素(T)及雌二醇(E2)水平,术后监测排卵情况、妊娠率及妊娠结果。结果术后血LH和T水平显著下降,LH由(22.36±3.17)U/L下降为(8.73±1.95)U/L,T由(4.54±0.72)pmol/L下降为(1.43±0.83)pmol/L(t=3.13,2.97;P<0.01)。术后排卵率81.6%(31/38),一年内累计妊娠18例,妊娠率为47.4%(18/38),早期流产率为11.1%(2/18)。38例月经情况(经量及持续时间)均较术前明显改善,月经周期28-55 d。结论腹腔镜卵巢多点打孔术能明显改善难治性PCOS患者的排卵和受孕机会,术后排卵率高,妊娠率高,流产率低,尤其对克罗米芬抵抗者不失为一个有效治疗手段。Objective To evaluate the efficacy of laparoscopic ovarian drilling for treating clomiphene-resistant polycystic ovary syndrome(PCOS).Methods Laparoscopic ovarian drilling,with pelvic adhesion release and salpingoplasty,was performed in 38 cases of clomipheneresistant PCOS from March 2001 to May 2005 in this hospital.Serum concentrations of luteinizing hormone(LH),follicle-stimulating hormone(FSH),androgen(T),and estradiol(E2) were measured before and after operation.Ovarian follicular development,pregnancy rate,and abortion rate were observed after operation. Results Postoperatively,there was a significant decline of levels of LH(from 22.36±3.17 U/L to 8.73±1.95 U/L;t=3.13,P<0.01) and T(from 4.54±0.72 pmol/L to 1.43±0.83 pmol/L;t=2.97,P<0.01).The ovulation rate after operation was 81.6%(31/38).Pregnancy within 1 year was observed in a total of 18 cases,the pregnancy rate being 47.4%(18/38).The early abortion rate was 11.1%(2/18).The menstruation(flow and duration) was remarkably improved postoperatively in 38 cases,with a menstrual cycle of 28~55 days.Conclusions Laparoscopic ovarian drilling can significantly increase the ovualation rate and pregnancy rate in patient with clomiphene-resistant polycystic ovary syndrome.

关 键 词：腹腔镜卵巢打孔术 多囊卵巢综合征 排卵 

分 类 号：R713.6[医药卫生—妇产科学]